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REVIEW  UPDATES ON MATERNAL FETAL MEDICINE 

Minerva Ginecologica 2019 April;71(2):133-45

DOI: 10.23736/S0026-4784.18.04324-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Management of gynecological cancer in pregnant patients

Stella CAPRIGLIONE 1, Aranzazu MANZANO 2, Ferdinando A. GULINO 3, Salvatore LOPEZ 2, 4

1 Department of Obstetrics and Gynecology, Institute for Social Security, Borgo Maggiore, San Marino; 2 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA; 3 Department of Obstetrics and Gynecology, Umberto I Hospital, Enna, Italy; 4 Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy



INTRODUCTION: Cancer during pregnancy is a rare but challenging condition. More women delay childbearing and consequently the incidence of cancer during pregnancy is constantly increasing.
EVIDENCE ACQUISITION: An extensive electronic search was performed in PubMed and Scopus. Only studies written after 1985 were considered eligible for this review. Abstracts, conference papers, book chapters, animal studies, commentaries as well as editorials articles were excluded from this review.
EVIDENCE SYNTHESIS: Cancer treatment during pregnancy is possible, but both maternal and fetal conditions need to be preserved. Randomized clinical trials are not feasible and current evidence are mainly based on case-series, small case reports and expert opinion. Cervical and ovarian cancers are the most common gynecological cancers diagnosed during pregnancy. Surgery and chemotherapy after the first trimester seem to be relatively safe for the newborn. Platinum-based chemotherapy administered during the 2nd-3rd trimester showed comparable adverse effects in newborns to those in the general population. Babies exposed to antenatal chemotherapy might be more likely to develop small for gestational age and NICU admission, than babies not exposed.
CONCLUSIONS: Management of pregnant women with cancer should be performed in specialized cancer centers and all cases should be discussed with a multidisciplinary approach. In the present review, we discuss the current recommendations for the management of pregnancies complicated by cancer and neonatal outcomes.


KEY WORDS: Pregnancy - Uterine cervical neoplasms - Ovarian neoplasms

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